go back

South Dakota rates for HCPCS 21263

Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement

Facilitymedian $3,467 · 10th–90th $2,239–$4,4670%20%10th90th$3,467Professionalmedian $2,884 · 10th–90th $2,089–$6,4570%10%10th90th$2,884$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,238.72 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,128.61 / $6,456.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,548.13 / $5,128.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,890.45 / $24,547.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,248.07 / $5,248.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $4,365.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,467.37 / $6,025.60
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,248.07 / $5,248.07